The Houston metro has added tens of thousands of new business applications every year since 2021. From the family-owned restaurants along Hillcroft to the construction crews building out Katy, these are companies where the owner handles payroll personally and losing one good employee changes everything. They represent the part of Houston’s economy that doesn’t always make the energy section of the Houston Chronicle but keeps the city running.
What too many of them struggle with is how to keep health insurance on the table for the people who make it all work. Some are trying to hold onto coverage they already offer. Others have never been able to afford it at all.
Texas leads the nation in uninsured residents, with roughly 1 in 5 Texans lacking coverage. In Harris County, competition for talent is fierce. As large employers in the energy, healthcare, and logistics sectors drive up the cost of benefits, local businesses are left with fewer affordable options for covering their workforce. Employers nationwide are facing projected health benefit cost increases above 6%, the steepest climb in more than a decade. For a local business that increase alone can cost more than a full-time salary.
“The business owners I talk to did everything right. They found a plan their employees could actually use, at a price that let them hold onto good people,” Shawne Hebert, a broker with SRC Financial Consulting said. “Now they’re seeing quotes come back that are double what they were paying, and the math changes everything downstream — you start losing the employees you invested in, the ones who stayed because you took care of them. Nothing about their business changed. The market changed around them.”
I’ve spent over two decades in healthcare, and I’ve watched this pattern play out in city after city. Costs climb, a plan disappears or gets priced out of reach, and coverage gets thinner for the employers who were already stretching to offer it. Employees who had a doctor they trusted found themselves starting over or going without. The cycle moves slowly enough that no single headline captures it, but the compounding effect on a community is real.
Houston is in one of those moments right now. Market shifts are reducing the number of affordable health plan options available to local businesses, and the employers who built their benefits around cost-conscious, locally focused plans are the ones feeling it most. These are employers who chose affordability because it was the only path to offering coverage at all. That decision was sound, and the instinct behind it — find a plan that fits your people and your budget — is exactly the right place to start from now.
Start with your broker and focus on these questions. Ask about plan structures that give you a fixed monthly cost and protect you from surprise claims at the end of the year. Demand pricing transparency so you can compare what you’re getting across carriers, not just what the premium number says. For most businesses, the priority isn’t the largest network — it’s ensuring employees can easily access the primary and urgent care services they use most often. A plan that fits the way your employees live is worth more than one with a name they recognize but can’t afford to use. Ask whether the plan keeps your employees connected to the doctors and facilities they already use. Continuity of care matters more than a network’s size on paper.
Preventive care matters, too. Plans that make it easy for employees to see a doctor before a minor issue becomes a major expense improve health outcomes while helping control long-term healthcare costs. For employers, those savings can make the difference between sustaining their benefits program and having to reconsider offering coverage at all.
Houston’s businesses are not waiting for someone to rescue them. They never have. But they deserve a healthcare market that works as hard as they do, with options built for how they actually operate. The talent they employ, the families they support and the neighborhoods they anchor all depend on it.
Ms. Duncan is the CEO of Texicare, a health insurance company focused on Texas businesses. She has spent over 18 years working in healthcare in Texas, previously holding leadership roles at Ascension, Aetna and Bright Health.
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